Sex After 40: Choosing the Right Contraceptive

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Women over 40 can enjoy satisfying sex lives, but their go-to form of birth control may need to change.

If you’re a woman over 40 who has sworn by the 30-day hormonal pill pack
for years, it might be time to reconsider your ideal form of birth
control. Your sex life might be the same, but your bodily needs have
changed in many ways.

The conversation about sexual health and
pregnancy tends to revolve around younger women at the most fertile time
of their lives, but pregnancy is still possible for women over 40, and
they still require contraception to maintain a worry-free sex life.

A
new study brings these issues to the forefront, exploring the most and
least effective forms of contraception for women over 40 and the risks
associated with each. Dr. Rebecca Allen of the Warren Alpert Medical
School at Brown University and fellow researchers published their
findings in the Canadian Medical Association Journal.

What Are the Risks and Benefits of Contraception for Older Women?

Because
the medical risks of pregnancy increase with age, contraception for
women over 40 is just as immediate a concern as it is for younger women.
There are risks and benefits associated with each form of
contraception, especially in conjunction with women’s changing bodies.

"Clinical
judgment will be required to balance the risks and benefits when a
woman has multiple medical conditions," Allen says. "The availability of
safe, effective options suggests that estrogen-containing methods
should increasingly be used with caution in older women who have
cardiovascular risk factors."

This is particularly true for oral
contraceptives, which can also prove less effective for women as they
grow older. The risks of oral contraceptive use in women over 40 include
cardiovascular complications, such as blood clots, and bone fracture
risks.

But the benefits can’t be overlooked, either. Women who
use oral contraceptives generally enjoy menstrual regularity, regulation
of vasomotor symptoms, such as hot flashes and night sweats, and a
decrease in the risk of endometrial cancer. The researchers suggest
non-hormonal and progestin-only birth control methods for women who have
been advised to avoid contraceptives containing estrogen.

According
to the study, the World Health Organization names copper intrauterine
devices (IUDs), progestin implants, and sterilization as the most
effective forms of birth control. The ideal for women over 40 is
generally long-acting, reversible contraception, such as an IUD.
This does not discount the effectiveness of short-term methods, such as
oral contraceptives, but these options should be assessed on an
individual basis.

In addition, while there are women over 40 who
are able to conceive without complications, all women should be aware of
the possible consequences. As the report states, “[t]he risk of
spontaneous abortion and chromosomal abnormalities increases markedly
after age 40. Older age is also associated with an increased risk of
obstetric complications, including gestational diabetes, hypertension,
placenta previa, cesarean delivery, perinatal death, and maternal
death.”

Why Is This Study Important?

With so many birth control options, choosing the most age-appropriate form of contraception can be challenging. Unintended pregnancies
are an issue for women of all ages, so they must be informed about what
works and what doesn’t, especially if they’ve trusted the same form of
contraception for years.

It comes as no surprise that women over 40 are still having sex, which comes with the same risks as sexual intercourse among any age group. But as women’s bodies change, so do their contraceptive needs and preferences. Fortunately, the number of options available for older women is increasing.

There’s
a contraceptive option for everyone. Comfort, safety, and preference
will help determine your ideal type so that you can enjoy a long and
healthy sex life.